USMLE Step 1 Pass Rates Decline Since Pass/Fail Change: What It Means for Faculty

What happened

In February of 2020, the NBME/FSMB announced that scoring for the Step 1 exam would change. As of January of 2022, instead of receiving a numeric score, medical students began receiving only a pass-fail result. 

Taking Step 1 is a major medical school milestone. At eight hours long and with up to 280 multiple choice questions covering a vast amount of basic science content related to medicine, this exam is often the predominant focus of the first half of medical school. Moreover, a student’s Step 1 score could impact whether they matched with their residency specialty and program of choice. 

Ensuring Step 1 success through adequate preparation, while also providing students with the breadth and depth of the medical sciences necessary to be successful, can be a challenging task for faculty and educators. How is the scoring change affecting this?

The impact

The data are still preliminary and more time and data are needed to better understand the impact on medical students and their residency application and match process. But, some interesting findings have emerged. Most notably, between 2021 (old graded version) and 2022 (new pass-fail version), Step 1 pass rates declined. 

For allopathic students, the Step 1 pass rate dropped from 95% to 91%. For osteopathic students, the passing rate decreased from 94% to 89%.¹ 

What does this mean for Step 1 preparation?

The exact causes and all of the contributing factors of this decline are unclear. But a key, take-home point is that passing Step 1 requires serious preparation. Students continue to need rigorous support and institutional resources for Step 1. In supporting students, consider the following:  

1. Identifying Step 1 study resources early in medical school can help students integrate these resources as they learn different topics. By using these resources in conjunction with their courses, they’ll be on solid footing when it comes time to review for Step 1. For example, Sketchy’s corresponding lessons and quiz questions are designed to create a strong, memorable foundation. Interested in bringing Sketchy to your school? Talk to our team!
2. Figuring out how to study all of the content covered on Step 1 can be overwhelming for students. To help, we’ve put together a Step 1 Content Review Guide. We break down content review on a weekly and daily basis. And if students are using Sketchy, we’ve included how to pair our lessons with their study plans.
3. Encourage or facilitate study groups. Although Step 1 is now pass-fail, preparing for it still requires significant motivation and dedication. A study group can provide support, keep students engaged, and provide a forum to share tools, resources, and study strategies—not just before an exam, but throughout the year. Sketchy’s interactive symbol explorer card is a great way for students to quiz each other on key, high-yield concepts.
4. Support students to get help early and as often as needed. Many institutions offer tutoring and other academic support services for free. 

While students won’t receive a numeric score after taking Step 1 anymore, the recent decline in Step 1 pass rates is a reminder of just how challenging this major exam is. At Sketchy, we have over a thousand lessons and thousands of quiz questions to make learning for Step 1 unforgettable.

^{1 https://www.usmle.org/performance-data}